Often A Health Care Laggard, U.S. Shines In Cancer Treatment

The U.S. ranks first in the world at stopping brain cancers, epidemiologists reported Monday. Here neurosurgeon Dr. Roger Hudgins and his assistant, Holly Zeller of Akron, Ohio, look at an MRI scan before performing surgery to remove a brain tumor.

How does the U.S. stack up against Western Europe when it comes to premature deaths? We've made progress against some cancers compared to other countries that spend a lot on health care, but lag behind on heart disease and diabetes.

In the U.S., teenagers and young adults are most likely to die from car accidents. Cancer and heart disease are the biggest problems for adults.

Courtesy of the Institute for Health Metrics and Evaluation.

Originally published on March 6, 2013 7:04 am

When it comes to the state of the nation's health, the U.S. seems to get one poor grade after another. Despite spending more on health care, we've been slipping behind other high-income countries for life expectancy and healthy living.

But when you drill down into the data and look at some specific diseases, there are areas where the U.S. isn't doing too badly at all, scientists from the Institute of Health Metrics and Evaluation reported Monday.

The U.S. tops the list at treating brain cancers and ranks third for colorectal cancer when compared to 18 other high-income countries. We're also doing better than average for strokes, falls, stomach cancer and breast cancer.

"Start with the simplest metric of health — death rates – and the U.S. does rather poorly compared to Western Europe, Canada, New Zealand and Australia," says Christopher Murray, director of IHME and a professor at the University of Washington. "But we've made a lot of progress in some of the cancers because of the aggressive treatments we do here," he tells Shots.

For many other diseases, though, the U.S. still has a lot of catching up to do.

When compared with European countries that spend quite a bit on health care, the U.S. fares worse than average for domestic violence, drug abuse and self-harm. And Greece is the only place in Western Europe with more deaths from road crashes than the U.S.

We rank nearly at the bottom for stopping some heart and lung diseases, diabetes and kidney problems. This cluster of illnesses, Murray says, is largely the consequence of Americans' biggest risk factors: poor diet, smoking and high blood pressure.

Last December, Murray and his team compiled a mammoth analysis of 235 causes of deaths worldwide and 67 risk factors for various illnesses in 2010. Their latest report, published Monday, takes a look country by country.

To help make sense of all these numbers, they've built some nifty tools for visualizing the data. You can compare disease prevalence and risk factors for each country and region. You can even zero in on dietary choices, such as average salt intake and omega-3 consumption, for each country.

"When you put all components of diet together, the U.S. is worse than all countries in Europe," Murray says. "But the U.K. comes close to us."

High blood pressure is still a major problem here, he says, but it's not dramatically worse than in many parts of Europe, including those countries that we associate with the Mediterranean diet.

"Take a place like Spain. Its burden of high blood pressure is about equal to that in the U.S. for women," Murray says. "That's probably because of their high consumption of processed meat."

Europe also shares the U.S.'s biggest cause of disability: back pain.

In fact, lower back pain was the leading cause of disability globally in 2010, with depression coming in second. Anxiety ranks in the top 10 everywhere in the world, except Eastern Europe and East Asia, while Alzheimer's disease and dementia have surged across high-income countries in the past decade.

"The medical profession hasn't been very successful at coming up with solutions and treatments for mental disorders and musculoskeletal disorders," Murray says. "We haven't had any major breakthroughs for these, like we have for cardiovascular disease."

This IHME work was sponsored by the Bill & Melinda Gates Foundation, which also supports NPR.

Other interesting patterns emerge when you look at regional levels, Murray says. For instance, there's a "homicide belt" that runs from Guatemala down to Brazil, in which murder is the dominant cause of death for men, and a "suicide belt" cuts through Southeast Asia to China, which primarily involves woman.

"There's always all these twists and turns to public health," Murray says. "That's why it's so important to have the risks and causes of deaths at the country level."